Care and mobility considerations

The amount of care and mobility requirements of someone with MS will vary from person to person.

Some people with only a short history but rapidly progressive form of the disease may require much more support than someone with a very slowly progressive form that they have had for over twenty years. Patients particularly with ‘Benign’ MS may well live an active, ‘normal’ life, including a full working life.

The most common symptoms of multiple sclerosis are weakness in one or more limbs, spasticity (muscle rigidity or pronounced stiffness) and spasms, especially in the legs, numbness and loss of sensation, pain, unsteadiness of gait, poor vision, fatigue and difficulties with speech and swallowing.

In the upper limbs, tremor, sufficient to interfere with everyday activities may develop.

As the condition progresses movements may become shaky, irregular and ineffective. Muscle weakness and spasticity may interfere with walking, sometimes eventually making it impossible while unsteadiness may lead to falls.

Difficulty with bladder control is very common and urinary symptoms are experienced by most people at some point. Bladder problems can affect the person's family, social life and work responsibilities. They include an urgent need to empty the bladder, having to use the toilet frequently, urinary tract infections and incontinence. Occasionally people are unable to empty their bladder without using a catheter.

Bowel problems include constipation, bowel urgency sometimes due to lack of sensation and faecal incontinence.

Impaired vision and weakness or tremor in the upper limbs may make the use of walking aids difficult or impossible and muscle fatigue, particularly when walking, may require the person to stop and rest at frequent intervals. Speech may become slow, slurred and hesitant and in the late stages of the disorder, dementia and mania (excessive elation) may also develop.

Therefore advanced stages of the disease lead to pronounced sensory and motor impairment and can be accompanied by significant cognitive and emotional problems. Short term memory often becomes impaired with poor attention and concentration and there may be depression or exaggerated emotional responses.

• Progression of Multiple Sclerosis
• Bowel incontinence
• H/R Mobility Severely Visually Impaired (SVI) deeming provisions

Amended April 2011